Fullerton, Susan

Fullerton, Susan is an individual health care provider with primary practice located at 4923 Ogletown Stanton Rd Suite 200, Newark DE 19713-2081. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Fullerton, Susan can be contacted via phone (302) 225-0451.

Contact Information

Primary practice address
4923 Ogletown Stanton Rd Suite 200 Newark DE 19713-2081
Phone: (302) 225-0451
Fax: (302) 225-0472
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X AC000097 Maryland
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X LG0000136 Delaware

Profile Details

NPI number 1295722155
LBN Legal business name Fullerton, Susan
Credentials Master of Science in Nursing (MSN)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 5th, 2005
Last updated Jun 15th, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295722155 NPPES
Maryland MEDICAID 404275100
Maryland MEDICAID 1000024659
Maryland MEDICAID 0046973

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